Central Billing Representative II

Under the supervision of the Central Billing Supervisor reporting to the Director of Revenue Cycle Management, this position is responsible for patient accounts receivable functions. Duties include reconciling, researching, correcting, and submitting third party claims, resolving claim issues with insurance and government payers, researching and correcting ICD-10, CPT coding and related codes. Provides customer service by resolving billing issues and reconciling remittance advice and patient accounts.

Responsibilities include:

• Reconcile and submit claim forms to third party payers
• Follow up and appeal claim denials
• Contact patients for claims information and payments
• Handle patient billing inquiries and complaints
• Maintain knowledge of Medicare, Medicaid, coding, and claims regulations
• Coordinate electronic patient statements monthly
• Prepare refund requests for overpayments
• Participate in billing helpdesk support
• Review outstanding accounts receivable and perform collections follow-up
• Edit and submit insurance claims
• Establish and monitor payment plans
• Process bad debt and account adjustments

Minimum qualifications:

• High school diploma or GED
• Two years billing/claims experience in healthcare or equivalent education
• Experience in multispecialty clinic preferred

Preferred certifications:

• Certified Coder (medical/dental), Billing Certificate, or demonstrated knowledge of CPT and ICD-10 coding

Skills:

• Knowledge of practice management systems, preferably Cerner EHR
• Ability to communicate tactfully with diverse groups
• Knowledge of HIPAA, CPT, DSM V, ICD-10, Medicare and Medicaid guidelines
• Familiarity with UB04, HCFA1500, electronic and paper claims
• High accuracy and attention to detail required
• Proficient with MS Windows and computer applications
• Ability to work independently and in teams
• Knowledge of Federally Qualified Health Care billing and compliance

Work conditions:

• Office environment, mostly sedentary work with minimal physical exertion
• Regular Monday-Friday schedule